Who cares who cares? (1988)

Editorial from the March 1988 issue of the Socialist Standard

Stirring the public conscience became part of the entertainment industry some time in the early eighties. At first, unsuspecting viewers in leafy suburbs noticed nothing more harrowing than malnutrition and death thousands of miles away, and threw loose change at the spectacle. A vogue for tales of glue sniffing and dragon chasing in dank, inner city garages then led to terrible addiction to earnest debate among experts, a form of exorcism which suddenly made way for a string of fresh concerns. Somewhere between Crimewatch and Hospital Watch was sandwiched a feast for the gourmet voyeur: documentaries on the growth of child labour and teenage prostitution down among the marginalised; telethons on children in need (quite obviously of money); phone-in shows on emotional and sexual problems; a shocker on "granny farming", an everyday story of secondhand car dealers in the geriatric marketplace; endless films and chat on the despair of daily life among the unemployed, with whom the majority appear happily to co-habit provided no intercourse takes place; cameos on frozen or battered pensioners, racist attacks and supplementary benefit poverty; specials on the plight of the homeless in wastelands of property development; stomach-churners on child abuse-, and offerings from socially aware dramatists. Most of this output was probably forgotten somewhere between the bus stop and coffee break next morning, but not before millions had dug deep into their pockets and come up with yet more fluff for the less fortunate. The day of the armchair Samaritan had dawned, the Thatcherite model citizen who tends his or her mortgaged garden but finds time to toss a coin or two in the direction of the gutter. Sniffing the stench of capitalism's less public parts can create a warm glow inside, provided pegs are firmly on red noses and everything is at arm's length.

Throwing money at problems is not, however, the government's idea of compassion: they favour a variant called "value for money", an incantation heard whenever rigor mortis of the fist sets in. Translated into English and seasonally adjusted, it means the ability to spend the very minimum consistent with the efficient running of capitalism without being rumbled - a tricky operation carried out on the National Health Service since its inception but undertaken recently without the aid of anaesthetic. An increasingly healthy competition for beds, medical equipment and operating time has driven thousands into the caring arms of private medicine, whose sunlit wards full of flowers and smiling nurses welcome any chronically ill worker with enough of the life-blood of our civilisation. The overwhelming majority will, as always, have to settle for the grossly inadequate, a state of affairs they have grown to accept stoically as inevitable. Recognition that their lives are conditioned and restricted by their social class may strike at times of adversity, but not to the point of challenging the notion of commercial exploitation of care for human beings at their most vulnerable.

While the government's supporters are concerned that the crisis could seriously damage their political health, opposition to present policies is based largely on a mythology fostered by proponents of the Welfare State and its institutions. Seen through Labour party eyes, the deterioration of health care is attributable to a congenital heart defect in the Prime Minister, a condition strangely absent when they themselves took a knife to the service in the seventies. Their picture of the NHS as a humane oasis in a desert of cost accountancy simply does not tally with experience. Like any expectant father, Beveridge wanted nothing but the best for his child: "a comprehensive national health service will ensure that for every citizen there is available whatever treatment he requires, in whatever form he requires it". Recalcitrant from its birth in the madhouse, the poor kid in fact made treatment available to the sick only because it contributed, in the short or long run, to the production of profit and the accumulation of capital. Resources were always expensive and therefore scarce; waiting lists long and periodically cleansed of impatient corpses; doctors, like Caesar, give the thumbs up or down to those jockeying for life-saving technology; and infant mortality rates continue to be determined by factors of class and occupation.

In a society where reality can increasingly be mistaken for a series of fast-moving, interwoven images of fact and fantasy, it is hardly surprising that response to the distress of others is numbed or stifled. The pursuit of self interest has led not to harmony and satisfaction but a tidal wave of disillusion and mean values lightly sprinkled with a token concern. Who's for opting out?